Child Dedication Request

Date of Dedication

Dedications are pre-scheduled quarterly. Please choose one of the next available dates below.

Your Phone

(###)

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Your Email

Child's Full Name

Please include middle name(s)

Child's Age

Please be advised that your child must be 3 years old or younger.

Onesie or T-shirt Size

Mother's Name

First Name

Last Name

Father's Name

First Name

Last Name

Maternal Grandparents

Paternal Grandparents

Godparents